BREAST ENGORGEMENT

CONTENT

-INTRODUCTION

-CAUSES

-SYMPTOMS

-TREATMENT

-COMPLICATIONS

-PREVENTION

 

INTRODUCTION

This is used to describe a condition in which the breasts become painfully over-filled with milk. It is commoner in first time moms who are faced with the task of learning for the first time, the art of breast feeding. It is important to recognize on time the features of breast engorgement as symptoms may worsen rapidly or become complicated by more sinister causes of breast pain, if not promptly managed. 

 

CAUSES

In general, any condition that results in significant disparity between the rate of milk production and rate of milk secretion or emptying, will result in breast engorgement due to a rapid accumulation of milk within the breast. Below is a list of the various causes of breast engorgement.

1.  POOR LATCHING OF THE BABY ON TO THE BREAST

By far, the commonest cause of breast engorgement is poor breast feeding technique. This results in poor latching of the baby on to the breast, which in turn results in poor sucking and emptying of the breast by the baby, eventually resulting in engorged breasts. Commoner among first time mothers, especially around the first week of delivery, when mothers are just learning how to breast feed and are yet to establish lactation; rapid milk production within the breast is usually unmatched by little or no milk emptying. To further make things worse, the poor latching of the baby often results in nipple injury and soreness which ultimately makes breast feeding more difficult, thereby worsening the breast engorgement. Occasionally, rare defects in the baby’s mouth, such as cleft lips may prevent the baby from properly latching onto the breast.

2.  CRACKED AND SORE NIPPLES

In many instances, nipples damage caused by poor latching of the baby on to the mother’s breast, such as cracked and sore nipples, may cause intense pain during breast feeding that may prevents proper and adequate breast feeding of the baby, leading to breast engorgement from inadequate breast emptying.  

3.  SUDDEN STOPPING OR REDUCTION IN RATE OF BREAST FEEDING

Often times when mothers begin to wean their infants or when they resume work or when they suddenly stop breast feeding for any other reasons, breast engorgement may occur due to continuous production of milk despite reduced or sudden stopping of breast feeding.

 

SYMPTOMS

1.  Swollen, firm and painful breasts which feels hard, shiny, warm, and slightly lumpy to touch.

2.  Flattened, hard nipples associated with a very firm areola making it hard for the baby to suck. This often results in a vicious cycle of more breast fullness and engorgement.

3.  Occasionally a slight fever and some swollen, tender lymph nodes may be present in the armpits.

 

TREATMENT

If breast feeding or just initiating breastfeeding, the following steps may relieve the symptoms and keeps the milk flowing;

1.  Soften your breast a few moment before each feed, by applying a warm compress for a couple of minutes or by express a small amount of milk from both breasts, either manually with your hand or with a breast pump. This will encourge the baby to latch on to the otherwise very firm or hard breast.

2.  Empty the breast more often, by breast feeding or by pumping out of milk from your breasts, if your baby is refusing to breast-feed, taking care to empty each breast one before the other on each occasion.

3.  Take a pain relief such as Paracetamol to reduce the pain. Your doctor may prescribe a more potent analgesics but always consult with your doctor before you take any drug while breastfeeding.

4.  Despite the above measures, if you still feel uncomfortable after nursing, try a cold compress using a frozen wet towel, a cold pack, or a bag of frozen vegetables in order to reduce the breast swelling. Apply this on your breasts for 15 minutes every hour as needed. To prevent damage to your skin, place a thin cloth between your breast and the cold pack.

If not breast-feeding, use one or more of these steps to relieve discomfort:

1.  Do not pump or remove a lot of milk from your breasts. If your breasts are very painful, it's okay to pump out just a little bit to make you comfortable. Pumping out large volume of milk will stimulate more milk production and worsen the breast engorgement.

2.  Apply a cold pack to your breasts for about 15 minutes every hour as required to relief your discomfort. Please make sure you place a thin cloth between your breast and the cold pack to prevent skin damage.

3.  Add Paracetamol tablets for pain control. Your doctor may need to prescribe a more potent analgesic if the Paracetamol is not adequately relieving the pain.

4.  Wear a tight fitting bra that provides good support for your breast. This helps to stop milk production and minimize the discomt from the very heavily engorged breast.

5.  In some instances, drugs that prevent milk production may be prescribed by your doctor if all the above measures fail.

 

COMPLICATIONS

1.  Worsening breast engorgement

2.  Worsening cracked and sore nipples

3.  Increasing difficulty in feeding the baby.

4.  Infection of the breast tissue. This is also known as mastitis.

 

PREVENTION

1.  From the above, it is obvious that the best way to prevent an engorged breast is to learn how to achieve a proper latch. For more information, please read the article, BREAST FEEDING: STEPS TO ACHIEVING A PROPER LATCH  

2.  Ensure continuous flow of milk out of the breasts either by breast feeding or by the use of a breast pump.

3.  Breast-feed the baby on demand taking note of hunger signs elicited by the baby such as sucking of the fingers by the baby. This may occur every other hour round the clock during the first few days and weeks of life.

4.  Ensure the baby is properly latched and is feeding well. If your breasts are hard and overfilled, let out or express enough milk just to soften the nipples and the breast, before putting the baby on to the breast.

5.  Empty the breasts with each feed ensuring that you empty one breast completely before switching to the other. To know when a breast is empty, observe when the baby either stop sucking or significantly slow down on sucking the breast, otherwise pay attention to when you stop hearing your baby’s swallowing noise.

With the above measures, you are very likely to adequately manage your engorged breasts at home. If despite these measures your symptoms persist, kindly please consult your doctor for a proper check up to rule out complications of breast engorgement or kindly CHAT WITH OUR CONSULTANTS.

 

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